Mt Shasta Medi-Cal Clinic, INC
NPI #1679514483 in Mount Shasta, California
Provider Information
- NPI Number
- 1679514483
- Entity Type
- Organization
- Organization Name
- Mt Shasta Medi-Cal Clinic, INC
- Primary Specialty
- Clinic/Center - Rural Health
- Enumeration Date
- Jun 10, 2006
- Last Updated
- Aug 4, 2009
Practice Location
- Address
- 912 PINE ST
- City
- Mount Shasta
- State
- California
- ZIP Code
- 96067-2143
- Phone
- (530) 926-5105
Authorized Official
- Name
- CHRIS BAYLESS, CMPE
- Title
- EXECUTIVE DIRECTOR
- Phone
- (530) 926-5105
Specialties & Taxonomy Codes
| Specialty |
|---|
| Clinic/Center - Rural Health — Rural Health |
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